title: Surgery or palliation for hip fractures in patients with advanced malignancy?
abstract: OBJECTIVE
  to investigate the management and outcome of patients with advanced cancer who sustain fractures of the neck of femur.
  
  
  METHODS
  multi-centre, prospective, observational study.
  
  
  METHODS
  patients with advanced malignancy, under the care of a palliative care team, who subsequently fractured a femur.
  
  
  METHODS
  survival time post-fracture, return home.
  
  
  RESULTS
  40 patients were recruited with a fractured neck of femur. Analysis of the management of patients according to the Eastern Co-operative Oncology Group performance score was undertaken. Twenty-nine patients were treated surgically and 11 conservatively. For patients with performance scores of 0, 1 and 2 surgery usually resulted in a successful rehabilitation outcome and discharge. None of those with scores of 3 or 4 returned home.
  
  
  CONCLUSIONS
  patients with advanced malignancy and a poor performance score should not be automatically referred for surgery.
authors.affiliation: Princess Alice Hospice, Esher, Surrey, UK.
authors.forename: P
authors.initials: P
authors.lastname: McNamara
authors.forename: K
authors.initials: K
authors.lastname: Sharma
mesh_terms: D000368:Aged; D005265:Femoral Neck Fractures / Q000601:surgery* / Q000628:therapy; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D010166:Palliative Care; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome